Friday, September 30, 2011
Elizabeth Sepper, Whose Conscience Counts? SSRN
Aaron Kesselheim & Rahul Rajkumar, Who Owns Federally Funded Research? The Supreme Court and the Bayh–Dole Act, N Engl J Med
Sharona Hoffman & Andy Podgurski, Balancing Privacy, Autonomy, and Scientific Needs in Electronic Health Records Research, SSRN/SMU L.Rev.
Thursday, September 29, 2011
Accountable Care Organizations (ACOs) are a hot health care reform topic. ACOs are supposed to improve quality and reduce waste by promoting coordination of care and best practices. But they could spur clinical and business relationships that run afoul of antitrust law and other federal and state regulation. On Oct. 28, 2011, Seton Hall University's Health Law and Policy Program will feature a stellar lineup of attorneys, academics, and physicians to address the thorny legal issues raised by (ACOs). The luncheon keynote speaker will be Dr. Jeffrey Brenner, founder of the Camden Coalition of Healthcare Providers. Dr. Brenner was featured by Atul Gawande in a New Yorker story that applauded his tireless work to improve the quality of care for disadvantaged individuals in South New Jersey. Brenner has demonstrated that a rational health care system can “lower medical costs by giving the neediest patients better care.”
For more information and the registration, click here.
Wednesday, September 28, 2011
[Dr. Polak] has focused on creating devices that will improve the lives of 2.6 billion people living on less than $2 a day. But, he insists, they must be so cheap and effective that the poor will actually buy them, since charity disappears when donors find new causes.
His greatest success has been a treadle pump that lets farmers raise groundwater in the dry season, when crops fetch more money. He has sold more than two million, he said. He also helped develop a $25 artificial knee and a $400 hospital lamp to save newborns with life-threatening jaundice.Dr. Polak's work reminded me of an inspirational conference in Boston, organized by Kevin Outterson, the Ewing Marion Kauffman Foundation, the Rhode Island College of Pharmacy, Universities Allied for Essential Medicines & Mind the Health Gap. Una Ryan, President & Chief Executive Officer of Diagnostics for All, gave a powerful presentation on her company's quest to bring tests to individuals for pennies. Developments like these indicate that conditions for the world's poorest can actually improve. X-Posted: Concurring Opinions. [FP]
Section 3025 of the Affordable Care Act, here, reduces Medicare payments by 1% in 2013, 2 % in 2014 and 3% thereafter for hospitals with exclusive readmissions. However, a report from the RWJ-funded Dartmouth Atlas Project, here examined 10.7 million Medicare discharges from almost 2000 hospitals from 2004-09. Their findings are disturbing; significant variations across hospitals and regions and, overall, no real progress nationwide in reducing the readmission rate. Indeed, almost half of the surveyed academic medical centers showed an increase in readmission rates. Will the imminence of CMS sanctions focus hospital attention on a potentially serious loss of revenue? And how will such readmission numbers caused by Hospital Acquired Conditions impact hospital revenues denied under state Medicaid programs as provided for by section 2702 of the Affordable Care Act and its resultant NPRM, here? [NPT]
Tuesday, September 27, 2011
Yesterday morning I brewed some tea, and then saw a newspaper story revealing that my town's water supply "contained high levels of lead," nearly "six times the national standard." Letters of warning has been sent out to residents, but I had not received mine - it came at noon.
As an environmental lawyer with knowledge about lead standards, I knew that lead is toxic over long priods, not just from limited morning teas. And I have always felt that the Safe Drinking Water Act (SDWA) has an adequate public notice section ("§141.85 Public education requirements") which requires customer notification to be "timely," and not more than 30 days. But I still resented being told yesterday about a problem discovered on August 30th. As the person ingesting the lead, I could not figure out why the chief water plant operator could not have picked up the phone and called the local newspaper the day he saw the test results. But the law did not require it - he just needed to provide the written notice within 30 days. "I did not try to drag it out" he said, "we're a small plant, we don't have great staffing, but I did it as fast as I could."
(I also learned that the water tanks were painted with lead based paint. As the plant operator candidly admitted, "I never thought they would put lead inside a tank.")
From a water consumer's standpoint, the SDWA regulations can be improved by simply adding a requirement for media announcements of standard violations. That may not reach everyone, and dissemination depends on outlets' decisions to carry the story. But it would have improved the likelihood that I would not have been drinking lead tainted tea for the past 25 days.
The White House has decided to forego a request for an 11th Circuit rehearing on the constitutionality of ACA (that likely would have delayed resolution to 2013) and go directly to the Supreme Court. Jennifer Haberkorn and Sarah Kliff have good pieces in Politico, here, and the Washington Post, here, discussing the reasons and ramifications.Will this be the most politically charged Supreme Court case since Bush v. Gore? Randy Barnett read those tea leaves 18 months ago, here. [NPT]